Yaşlılarda Basınç Yaralanması Risk Faktörleri

Year 2019, Volume: 2 Issue: 2, 50 - 57, 31.08.2019

Emine Sezgünsay , Tülay Başak

Abstract

Uygun
bakım planlamaları ile önlenebilen basınç yaralanmaları, özellikle fiziksel
olarak sınırlı veya yatağa bağımlı yaşlılarda yaygın bir sağlık problemidir.
Yaşın ilerlemesi sonucu diğer tüm organ
sistemlerinde olduğu gibi, derinin tüm düzeylerinde yaşlanma ile ilişkili
değişiklikler oluşur.  Hareketsizlik,
beslenme eksikliği ve çoklu
sistemlerdeki bozulmaların kronik hastalıklarla birleşmesi neticesinde
yaşlılarda yaşlanan cildin kırılganlığı artmaktadır. Demans, serebrovasküler
hastalık veya Alzheimer hastalığı gibi nörolojik
hastalıklarda gözlemlenebilen değişik düzeylerdeki duyusal algılama
bozuklukları, ajitasyon veya mobilizasyon bozuklukları yaşlı bireyin basınç
yaralanması riskini arttırır. Bunun yanında mikroorganizmalara karşı
koruyuculuğun, kollajen yapımının ve immün yanıtın azalması yaşlı bireyde
basınç yaralanmalarının oluşumunu tetikleyen ve yara tedavisini olumsuz
etkileyen ek faktörlerdir. Yaşlılarda basınç yaralanması riskini arttıran bir
diğer faktör ise malnütrisyondur. Gerek ev ortamında gerekse sağlık hizmeti
sunan kurumlarda yaşlı bireyde malnütrisyon gelişme ihtimali yüksektir. Enerji
ve sıvı alımındaki yetersizlikler, vitamin ve mineral eksiklikleri ile
birleşerek doku bütünlüğünün devamlılığının sağlanmasını olumsuz yönde etkiler.
Basınç yaralanmaları meydana geldiğinde tedavisi zor ve maliyetlidir. Oluşan
yaralanma hastanın ve hasta yakınlarının günlük yaşamını etkileyen ve hastayı
sosyal izolasyona sürükleyebilen bir problem haline gelebilmektedir. İleri evre
basınç yaralanmaları kronik yaralar halini alarak yaşamının kalan kısmında
yaşlı bireyin rehabilitasyon ihtiyacını arttırabilir. Yaşlı bireyin basınç
yaralanması bakımı; hastanın, hasta yakınlarının ve sağlık hizmet sunucularının
iş yükünü arttırırken, maddi kayıplara neden olmaktadır.

Yaşlılarda
basınç yaralanması yaklaşımının birinci basamağı basınç yaralanmalarının
oluşmadan önlenmesidir. Önlemenin
anahtarı ise yaşlı bireylerin basınç yaralanması riski oluşturan faktörleri
doğru şekilde tanımlamak, kanıta dayalı önleyici bakım tedbirlerini planlamak
ve uygulamaya sokmaktır. Bu makalede cilt yaşlanması, yaşlılığa eşlik eden
hastalıklar, bilişsel bozukluklar, beslenme yetersizlikleri gibi yaşlılarda
basınç yaralanması gelişimine neden olan
risk faktörleri incelecektir.

Keywords

Basınç yaralanması, hemşirelik, yaşlı, risk değerlendirmesi

Pressure Injury Risk Factors in Elderly

Abstract

Pressure injuries that can
be prevented by appropriate care planning are a common health problem
especially in physically limited or bed-bound elderly. As a result of the
progression of age, as with all other organ systems, aging-related changes
occur at all layers of the skin.  As a
result of the combination of immobility, nutritional deficiency and disruption
of multiple systems with chronic diseases, the fragility of the aging skin of
the elderly increases. Sensory perception disturbances, agitation or limited
mobility at different levels that can be observed in dementia, cerebrovascular
disease or neurological diseases such as Alzheimer's disease increase the risk
of pressure injury to the elderly.  In
addition, protection against microorganisms, collagen synthesis, and reduced
immune response are additional factors that trigger the formation of pressure
injuries in the elderly and adversely affect wound treatment. Malnutrition is
another factor that increases the risk of pressure injury in the elderly. Malnutrition
is a high probability of development in elderly people in both home and health
care institutions. The inadequacies in energy and fluid intake, negatively
affect the continuity of tissue integrity combined with vitamin and mineral
deficiencies. When pressure injuries occur, treatment is difficult and costly.
The resulting injury can become a problem that affects the daily life of the
patient and his / her relatives and may lead the patient to social isolation.
Advanced stage pressure injuries can become chronic wounds and may increase the
rehabilitation needs of the elderly person in the rest of life. Pressure injury
care of the elderly increases the workload of the patient, patient relatives, and
health service providers and causes financial losses.

The first step of the
pressure injury approach in the elderly is to prevent pressure injuries before
they occur. The key to prevention is to correctly identify the factors that
create the risk of pressure injury for elderly individuals, to plan and implement
evidence-based preventive care measures. In this article, it will be examined
the risk factors that cause pressure injury in the elderly such as skin aging,
diseases concomitant with old age, cognitive disorders and nutritional
deficiency.

 

Keywords

Pressure injury, nursing, elderly, risk assessment

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